Adult Urinary Tract Infection (UTI) Treatment (Acute Cystitis)
Burning with urination, urinary urgency, and pelvic discomfort are classic signs of a urinary tract infection. TeleDirectMD connects you with a board-certified MD for guideline-based evaluation and, when appropriate, same-day antibiotic treatment by secure video visit.
- $49 flat-fee visit, no surprise bills
- MD-only care, no mid-level substitutions
- No insurance required, HSA/FSA-friendly
- Available in 25+ states by secure video visit
TeleDirectMD is physician-led virtual urgent care. Every visit is with a real doctor, Parth Bhavsar, MD.
What Is a Urinary Tract Infection (UTI)?
A urinary tract infection (UTI) is a bacterial infection involving the bladder and urethra, most often causing burning with urination, urinary urgency, and the feeling of needing to go even when the bladder is nearly empty. In adults, uncomplicated acute cystitis can be safely evaluated and treated by telehealth when there are no concerning red flags for kidney infection, pregnancy complications, or serious systemic illness.
During your TeleDirectMD visit, an MD uses evidence-based criteria to distinguish uncomplicated acute cystitis from kidney infection, stones, or noninfectious causes of urinary symptoms. When antibiotics are truly indicated, we follow antibiotic stewardship principles to choose an appropriate regimen and duration.
Symptoms and Red Flags for Adult UTIs
This table highlights typical features of uncomplicated UTIs versus findings that should trigger in-person care.
| Symptom | What It Suggests | Telehealth Appropriate? | Red Flag Requiring In-Person or ER Care |
|---|---|---|---|
| Burning with urination (dysuria) | Classic sign of acute cystitis or urethral irritation | Yes, if no fever, flank pain, or pregnancy | Seek urgent care if severe pain with fever or visible blood clots |
| Urinary urgency and frequency | Common with bladder inflammation from UTI | Yes, especially in otherwise healthy nonpregnant adults | In-person evaluation if unable to pass urine or severe pelvic pain |
| Foul-smelling or cloudy urine | May occur with bacterial UTI but can also be benign | Yes, telehealth can evaluate in the context of other symptoms | In-person testing if accompanied by systemic illness |
| Visible blood in urine (hematuria) | May be seen with UTI, stones, or other urologic issues | Telehealth can triage, but follow-up testing is often recommended | ER care if heavy bleeding, clots, or associated dizziness or weakness |
| Fever, chills, or feeling very unwell | Concerning for kidney infection or systemic infection | No, this goes beyond uncomplicated telehealth UTI care | Needs urgent in-person evaluation or ER visit |
| Flank or back pain under the ribs | Raises concern for kidney infection or stones | No, should not be managed as simple cystitis online | Go to urgent care or ER for exam, labs, and possible imaging |
| Nausea, vomiting, or unable to keep fluids down | Suggests more severe infection or dehydration | No, telehealth alone is not appropriate | Requires in-person urgent or emergency care |
| Pregnancy with urinary symptoms | Higher-risk situation needing closer monitoring | Telehealth can triage, but in-person care is usually recommended | ER if fever, flank pain, contractions, or severe illness |
| Symptoms in adult men | May represent prostatitis or complicated UTI | Telehealth can triage, but often needs in-person exam | Urgent in-person evaluation if fever, pelvic pain, or urinary retention |
| Recurrent UTIs (three or more per year) | May indicate underlying anatomic or functional issues | Telehealth can manage acute episodes and advise on workup | In-person follow-up with primary care or urology is recommended |
How We Distinguish UTIs from Other Urinary Problems
Not all urinary burning or frequency is caused by a bacterial UTI. During your video visit, your TeleDirectMD physician takes a detailed history to separate uncomplicated acute cystitis from other causes of urinary symptoms.
- Acute cystitis: Burning with urination and urinary frequency in an adult without fever or flank pain, most often in otherwise healthy nonpregnant women.
- Vaginal infections (BV or yeast): More likely to cause discharge, odor, irritation, and itching, with burning that feels external rather than deep inside the bladder.
- Sexually transmitted infections: Can mimic UTI but often include discharge, pelvic pain, or a history of recent exposure that changes the testing and treatment plan.
- Kidney infection (pyelonephritis): Typically causes flank pain, fever, chills, or systemic illness and requires in-person evaluation, labs, and sometimes imaging.
- Kidney stones and other urologic conditions: May cause blood in urine, severe colicky pain, or recurrent symptoms that do not fit a simple UTI pattern.
- Noninfectious causes (irritation, interstitial cystitis): Symptoms can be chronic or recurrent without clear infection; telehealth can help with triage, but long-term management usually involves in-person care.
Our goal is to treat true UTIs promptly while avoiding overuse of antibiotics when symptoms suggest another diagnosis.
When a Video Visit Is Appropriate for UTI Symptoms
When a TeleDirectMD Video Visit Is Appropriate
- Adult, generally healthy, nonpregnant
- Burning with urination plus urinary urgency or frequency
- No flank pain, high fever, or vomiting
- First or infrequent UTI episodes in the past year
- Able to drink fluids and keep down medications
- Comfortable using a nearby pharmacy for prescriptions
Red Flags Requiring In-Person or ER Care
- High fever, chills, or feeling severely ill
- Significant flank or back pain under the ribs
- Persistent vomiting or inability to keep fluids down
- Pregnancy with UTI symptoms
- Urinary symptoms in adult men with fever or pelvic pain
- History of kidney disease, transplant, or marked immune suppression
- Very low blood pressure, confusion, or signs of sepsis
If any red flag is present, do not rely on virtual care alone. Seek urgent in-person or emergency evaluation promptly.
How TeleDirectMD Treats Adult UTIs
TeleDirectMD focuses on safe, evidence-based prescribing and antibiotic stewardship. Not every urinary symptom requires an antibiotic, and not all antibiotics are equally appropriate in every patient.
Supportive Care
- Encouraging adequate oral fluid intake to maintain hydration
- Using over-the-counter pain relievers such as acetaminophen or ibuprofen when appropriate
- Avoiding bladder irritants such as caffeine, alcohol, and strongly acidic beverages
- Discussing short-term use of urinary analgesics when safe and indicated
First-Line Antibiotic Treatment
When your TeleDirectMD physician confirms uncomplicated acute cystitis with no red flags, an oral antibiotic may be prescribed. We avoid routine fluoroquinolone use for simple UTIs because of safety concerns and resistance patterns.
Antibiotic Stewardship
- Antibiotics are prescribed only when the history strongly supports bacterial infection
- Medication choice and duration follow adult guideline recommendations when applicable
- We avoid unnecessarily broad-spectrum antibiotics when narrower agents are suitable
- Patients receive clear instructions on expected improvement and warning signs
Common Medications for Adult UTIs
Dosing is always individualized based on allergies, kidney function, other medications, and pregnancy status. The table below shows commonly used options for uncomplicated acute cystitis in adults.
| Medication | Dose | Duration | When It Is Used |
|---|---|---|---|
| Cephalexin | 500 mg by mouth twice daily | 5–7 days | Common first-line option for uncomplicated UTI in nonpregnant adults without severe beta-lactam allergy |
| Nitrofurantoin (macrocrystal/monohydrate) | 100 mg by mouth twice daily | 5 days | Used for lower tract infections when kidney function is adequate; not used for suspected kidney infection |
| Trimethoprim-sulfamethoxazole | 1 double-strength tablet by mouth twice daily | 3 days | Considered when local resistance rates are acceptable and there is no sulfa allergy or significant drug interaction |
| Fosfomycin tromethamine | 3 g by mouth once | Single dose | Selected cases of uncomplicated cystitis, depending on availability and individual factors |
TeleDirectMD does not routinely use fluoroquinolone antibiotics for uncomplicated UTIs and reserves them for specific situations when safer options are not appropriate.
Home Care, Monitoring, and Return to Work
Most adults with uncomplicated acute cystitis start to feel improvement within 24–48 hours after starting an appropriate antibiotic. Your TeleDirectMD physician will explain how to monitor your symptoms and when to escalate care.
- Take the antibiotic exactly as prescribed, even if symptoms improve early
- Stay well hydrated unless you have been told to limit fluids for another condition
- Use the restroom regularly and avoid holding urine for long periods
- Avoid new perfumed products or harsh soaps around the genital area
- Avoid sexual activity until symptoms have clearly improved to reduce discomfort and irritation
- Seek in-person care promptly if symptoms worsen, new fever or flank pain develops, or vomiting persists
Many adults can work during treatment for an uncomplicated UTI once pain and urgency begin to improve. If you feel too unwell to work, short-term rest may be appropriate. Limited work notes can be discussed during the visit, in line with TeleDirectMD policies.
TeleDirectMD provides MD-only virtual urgent care for adults through secure video visits at a $49 flat-fee price point, available in 25+ states. We do not prescribe controlled substances and we follow evidence-based guidelines for every condition, including urinary tract infections. Some situations require in-person evaluation, testing, or emergency care. Your TeleDirectMD physician will be clear about what telehealth can and cannot safely manage so you know what to expect.
Clinical content reviewed by Parth Bhavsar, MD.
Frequently Asked Questions about Online UTI Treatment
Can a doctor accurately diagnose a UTI by video visit?
In adults with classic symptoms of acute cystitis, a detailed history is often enough to make a reliable diagnosis. TeleDirectMD physicians use guideline-based questions to distinguish uncomplicated UTIs from more serious infections and will recommend in-person testing when needed.
Do I always need antibiotics for burning with urination?
No. Burning with urination can be caused by bacterial UTI, but also by vaginal infections, irritation, or other conditions. TeleDirectMD prescribes antibiotics only when the history strongly supports a bacterial infection and the benefits outweigh the risks.
How quickly will I start to feel better after starting treatment?
Many adults notice improvement within 24–48 hours after starting an appropriate antibiotic for an uncomplicated UTI. If symptoms worsen, or if fever or flank pain develops, in-person evaluation is recommended.
When are urine tests or cultures needed for a UTI?
Urine testing becomes more important when symptoms are atypical, infections are recurrent, the patient is pregnant, treatment has failed, or there are other risk factors. TeleDirectMD can advise when local testing or in-person follow-up is needed.
Are there situations where TeleDirectMD will not treat a UTI online?
Yes. TeleDirectMD does not manage suspected kidney infections, sepsis, severe systemic illness, or complex urinary problems solely by telehealth. Red flags such as high fever, flank pain, vomiting, pregnancy complications, or very low blood pressure require in-person urgent or emergency care.
Can TeleDirectMD treat UTIs in pregnant patients?
TeleDirectMD can help triage symptoms in pregnant patients, but ongoing management and antibiotic selection usually require in-person obstetric or primary care evaluation. Your doctor will be clear when in-person follow-up is recommended.
Is online UTI treatment safe for adult men?
Urinary symptoms in adult men may represent prostatitis or complicated infection. TeleDirectMD can triage symptoms, but many men with urinary issues benefit from an in-person exam and testing instead of simple telehealth management.
What if my UTI keeps coming back?
Recurrent UTIs may require additional evaluation for underlying causes such as anatomic differences, bladder dysfunction, or hormonal changes. TeleDirectMD can treat an acute episode and guide you on when referral to primary care or urology is appropriate.
Can I return to work while being treated for a UTI?
Many adults can work during treatment once pain and urgency improve. If you feel significantly unwell, short-term rest may be appropriate. Documentation needs can be discussed during your visit, within TeleDirectMD policies.
What makes TeleDirectMD different from other telehealth UTI services?
TeleDirectMD is MD-only, uses a flat $49 fee, and operates in 25+ states with a focus on evidence-based care and antibiotic stewardship. Patients see a board-certified physician, and each visit includes clear guidance on when telehealth is appropriate and when in-person care is safer.